| NPI | 1124587704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MO 2018035806) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: KS 208) |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2019-03-13 |